Immigrants Begin To Join Health Care Plan

Thousands Now Eligible To Join

UPDATED 10:29 AM EDT Apr 06, 2012

BOSTON -

The agency overseeing Massachusetts' landmark health care law has begun enrolling thousands of legal immigrants into the subsidized insurance program after the state's highest court ruled that state lawmakers unconstitutionally denied the benefit to foreign-born residents who have been in the country for less than five years.

State lawmakers voted in 2009 to cut funding for low-income immigrants enrolled in Commonwealth Care because the federal government does not reimburse states for dental, hospice, skilled-nursing care and other costs incurred by foreign-born residents living in the country for less than five years.

The immigrants were transferred to another state program that offered limited coverage, while thousands of others were put on a waiting list. The action, intended to help plug a $1.9 billion budget deficit, marked the first significant rollback to the health care law that was signed by then-Gov. Mitt Romney, a Republican, in 2006.

The Supreme Judicial Court, however, ruled unanimously in January that preventing immigrants from enrolling in Commonwealth Care was unconstitutional because it violated their rights to equal protection under the Massachusetts Constitution. Judges said state officials couldn't justify their exclusion on the basis of fiscal concerns alone.

About 26,000 immigrants who were on the waiting list have begun receiving letters telling them that they are eligible to enroll into the Commonwealth Care and MassHealth, the state's Medicaid program, and instructing them how to join, said Dick Powers of the Massachusetts Health Connector, an independent state agency that oversees the health care law.

Those letters began going out in three waves beginning March 26, with the third and final batch expected to be mailed on Monday, Powers said.

Members of the Massachusetts Immigrant and Refugee Advocacy Coalition and colleagues from Health Care for All, whose nonprofit law firm sued the state to restore subsidized health care for foreign-born residents, are warning the recipients of the letters that failure to actively enroll in the health plans will cause them to lose access to physicians for primary care as well as preventive care visits, which are key to staying healthy and containing long-term costs.

"The window of opportunity is only 90 days long, and without taking action consumers could lose access to coverage and become uninsured," the two groups said in a joint statement.

Health Care for All will help immigrants determine if they are eligible for the program and assist them with enrollment, said Amy Whitcomb Slemmer, the group's executive director.

About 13,400 immigrants who were previously in Commonwealth Care but were later transferred to the program with lesser coverage, known as Commonwealth Care Bridge, have been automatically re-enrolled in the original program. The move occurred on March 1, Powers said.

"These tax-paying legal immigrants have the same rights to health insurance in Massachusetts as everybody else," Powers said.

Massachusetts is among the nation's top destinations for immigrants, ranking 7th among states hosting foreigners holding so-called green cards that are given to legal permanent residents. The state was home to 320,000 such residents in 2010, accounting for 2.5 percent of legal immigrants in the nation, according to the federal Department of Homeland Security.

The addition of 26,000 new subsidized health insurance beneficiaries is expected to add as much as $150 million to the annual cost of covering new immigrants, Massachusetts finance officials have said.

"We do have sufficient funding in our budget for the current fiscal year to enroll these people, so it will not require any additional funding this year," Powers said.

How the state will cover the costs in the next fiscal year, starting July 1, is an unresolved question. Gov. Deval Patrick has proposed raising taxes on cigarettes and other tobacco products and using the money to offset the additional health care expenses, but House Speaker Robert DeLeo has ruled out new taxes in the House budget expected to be unveiled next week.

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